Quantifying Laryngopharyngeal Reflux in Singers: Perceptual and Objective Findings.

This study examines the relationship between laryngopharyngeal reflux (LPR) symptoms and oropharyngeal pH levels in singers. We hypothesized that reported symptoms would correlate with objective measures of pH levels from the oropharynx, including the number and total duration of reflux episodes. Twenty professional/semiprofessional singers completed the Reflux Symptom Index (RSI) and underwent oropharyngeal pH monitoring.

Designing Real-time Decision Support for Trauma Resuscitations.

Background: Use of electronic clinical decision support (eCDS) has been recommended to improve implementation of clinical decision rules. Many eCDS tools, however, are designed and implemented without taking into account the context in which clinical work is performed. Implementation of the pediatric traumatic brain injury (TBI) clinical decision rule at one Level I pediatric emergency department includes an electronic questionnaire triggered when ordering a head computed tomography using computerized physician order entry (CPOE).

Management of Dysphagia Pre- and Postoperatively in a Case of Eagle's Syndrome.

Eagle's syndrome (ES) is rare condition, most frequently described within the context of case study presentation. ES results from elongation of the styloid process, contributing to symptoms such as globus sensation in the throat, as well as pain localized to the ear, neck, face, or tongue. Additional symptoms can include hypersalivation, change in vocal quality, submandibular swelling, and dysphagia.

Successful patient diabetes education in the emergency department.

Purpose: The purpose of this study was to examine the effect of diabetes self-management education (DSME) provided in a large urban emergency department (ED) by a certified diabetes educator using a "learner-centered" approach to teaching survival skills. It was hypothesized that an intervention providing learner-centered education in the ED would significantly improve diabetes knowledge and self-management skills.

Methods: Participants were patients who presented to the ED with uncontrolled blood glucose with type 2 diabetes mellitus (T2DM).

Reducing healthcare-associated infections in an ambulatory dialysis unit: Identification and alignment of work system factors.

Background: Patients undergoing hemodialysis have experienced a 43% increase in rate of hospitalization due to infection during the past 20 years. Research in other industries has shown that safe systems are achieved by considering the entire system to enable performance specifications to be met.

Method: A sociotechnical systems framework was applied through the Macroergonomic Analysis and Design method to evaluate a 54-chair ambulatory dialysis unit to decrease healthcare-associated infections.

Improved voluntary cough immediately following office-based vocal fold medialization injections.

Objectives/hypothesis: This study examined changes in voluntary cough airflow measures immediately following in-office injection of Radiesse in patients diagnosed with glottic insufficiency. Due to significant comorbidities, these patients were poor candidates for medialization under general anesthesia. Each patient presented with dysphonia and dysphagia and ineffective voluntary cough, resulting in a poor clearing of secretions and a presence of ingested fluids on examination.

An evidence-based toolkit for the development of effective and sustainable root cause analysis system safety solutions.

Root cause analysis (RCA) after adverse events in healthcare is a standard practice at many institutions. However, healthcare has failed to see a dramatic improvement in patient safety over the last decade. In order to improve the RCA process, this study used systems safety science, which is based partly on human factors engineering principles and has been applied with success in other high-risk industries like aviation.

Defining the pharmaceutical system to support proactive drug safety.

The military, aviation, nuclear, and transportation industries have transformed their safety records by using a systems approach to safety and risk mitigation. This article creates a preliminary model of the U.S.

A roundtable discussion: home healthcare-not a hospital in the home.

Home healthcare is vital for a large percentage of the population. According to data from the U.S.

The role of the speech-language pathologist in the schools for the treatment of voice disorders: working within the framework of the individuals with disabilities education improvement act.

The role of the speech-language pathologist (SLP) has developed considerably over the past 20 years given the medical and technological advances in life-sustaining procedures. Children born with congenital, surgical, or "medically fragile" conditions become mainstreamed into regular school-based settings, thus extending the traditional role of the treating SLP and multidisciplinary team. Understanding the impact of associated voice disorders on educational performance requires dissemination of additional and important information, as eligibility decisions for students in school-based settings must be made within the framework of the federal legislation and regulations governing the provision of services for students with disabilities.

Increased age is an independent risk factor for radiographic aspiration and laryngeal penetration after thoracotomy for pulmonary resection.

Objectives: Aspiration is an increasingly recognized complication after thoracotomy for pulmonary resection, but mechanisms of postoperative aspiration are poorly characterized. This study sought to evaluate risk factors to better define postthoracotomy aspiration.

Methods: Three hundred twenty-one consecutive patients underwent clinical bedside swallowing evaluations after thoracotomy for pulmonary resection on postoperative day 1.

What information do clinicians use in recommending oral versus nonoral feeding in oropharyngeal dysphagic patients?

There is little evidence regarding the type(s) of information clinicians use to make the recommendation for oral or nonoral feeding in patients with oropharyngeal dysphagia. This study represents a first step toward identifying data used by clinicians to make this recommendation and how clinical experience may affect the recommendation. Thirteen variables were considered critical in making the oral vs.

Mass psychogenic illness presenting as acute stridor in an adolescent female cohort.

Objectives: We describe a cohort of patients with an unusual presentation of stridor, their evaluation and management, and their outcome. We review the pertinent English-language literature.

Methods: We performed a retrospective review of the records of 12 adolescent patients treated for acute-onset inspiratory stridor at the Departments of Otolaryngology-Head and Neck Surgery and Allergy and Immunology at the University of South Florida and the Department of Speech Pathology at the H.

Routine evaluation for aspiration after thoracotomy for pulmonary resection.

Background: The purpose of this study was to evaluate the role of a routine protocol for evaluation of oropharyngeal aspiration after thoracotomy for pulmonary resection.

Methods: Demographic, operative, and outcomes data were collected prospectively for consecutive patients undergoing thoracotomy for pulmonary resection starting in April 2005. Starting on postoperative day one, patients underwent evaluation by a licensed speech therapist before per os intake.